1 88 PHYSIC 



super-added microbism, to be dealt with rigorously from 

 the preventive point of view, the principles of which should 

 almost at once and spontaneously be indicated or present 

 themselves. That leprosy has been geographically limited 

 in incidence, racially somewhat locally circumscribed in 

 spread, and, as to individual cases, that they generally have 

 been surrounded by somewhat questionable sanitary con- 

 ditions, and, it may be, personal neglect of bodily cleanli- 

 ness, with the continuous use of questionable articles of 

 diet, as has been from time to time contended, give a 

 warrant to the assumption that it is a disease absolutely 

 capable of extinction by properly directed preventive 

 measures and the education of public opinion as to the 

 great possibilities underlying and flowing out of the con- 

 tinued and world-wide influence of the rigorous adminis- 

 tration of the needful preventive and other measures. 



We have claimed leprosy as a disease primarily of the 

 nervous system, and we are quite aware that the claim is. 

 founded on nothing more or less than rank heterodoxy ;; 

 nevertheless, we are prepared, we think and say, to demon- 

 strate that, on anatomical, histological, pathological, and 

 clinical grounds, we are warranted in making the claim 

 and in rejecting the others, so far as we have been able 

 to gather from available literature on the subject, as. 

 coming far shorter of the requirements necessitated than 

 that which we now and here advance. The universally 

 cutaneous sites chosen by the disease, the years long 

 incubatory progress characterising it, the greater or lesser 

 neural destruction wrought by its pathological incidence 

 and influence, the consistence and composition of the 

 leprous exuviae, the frequent symmetrical distribution of 

 the morbid phenomena, and the correspondence in locale 

 of the cutaneous involvements, with the anatomical distri- 

 bution of the peripheral sensory nervature, all proclaim 

 its nervine origin and incidence. These facts, in conjunc- 

 tion with the bacterial invasion of the resultant neuro- 

 dermal exudations, give the key, therefore, in our opinion^ 

 to the true pathology of the affection, provide indica- 

 tions for a more hopeful treatment, preventive, curative, 

 and ameliorative, than has hitherto been possible, and 

 bring the disease into the category of affections of which: 



